Measuring and mitigating the risk of mycotoxins in

maize and dairy products for poor consumers in Kenya

Johanna Lindahl, Delia Grace, Vesa Joutsjoki, Hannu Korhonen and Vivian Hoffmann
Presentation outline

• Food safety
• Aflatoxin contamination
• Globally
• Our work in Africa

• What do we do about it?

• Mitigation strategies at different levels
 Food safety- more than aflatoxins
20,000,000

18,000,000
Disability adjusted life years (DALY)

16,000,000

14,000,000

12,000,000
Other toxins
10,000,000 Aflatoxins
Helminths
8,000,000
Microbial
6,000,000

4,000,000

2,000,000

0
Asia Africa Other developing Developed

Havelaar et al., 2015

 Milk safety

Pathogens from the cow and from the milk

• Mycobacterium • Streptococcus spp.
bovis • Staphylococcus
• Brucella spp. aureus
• Bacillus anthracis • Clostridium spp.
• Salmonella • Listeria spp.
• EHEC
What else is in the milk?

• Microbial load
• Adulterants
What else is in the milk?

• Antibiotic residues
• Pesticides
• Mycotoxins: aflatoxins
 What are mycotoxins?

• When some moulds grow on crops, they

produce toxic substances that can remain in
the crops
• Moulds are ubiquitous

Photo by IITA. Aspergillus naturally infected groundnuts in Mozambique.

Photo by CIMMYT.
 Aflatoxins

• Toxic byproducts from Aspergillus fungi

– Mainly Aspergillus flavus
– Not all toxigenic
– Preference for maize, groundnuts, but also other
cereals
Staples!
 Aflatoxins

• Different kinds
– Invisible
– Odourless
– Tasteless
– Heat stable

We feed it to our children

 The health concerns
• Acute outbreaks can claim 100s of lives
(Kenya outbreak 2004-2005 125 known fatal
cases)
• 4.5 billion people chronically exposed
(estimate by US CDC)
• Cancer
• Immunosupression
• Stunting
 Stunting?

• Low height for age

• Why?
– Leaky gut
– Immunity
 Global issue
• Estimated that total mycotoxin losses in the states
are 1.4 billion USD annually
• Some years farmers are forced to dispose of half
their crops of corn and peanuts
Aflatoxins are a global issue
CGIAR are global institutes

International Food
International Maiz Policy Research Ins
e and Wheat Impr titute (IFPRI)
ovement Center (C International Crops
IMMYT) Research Institute
for the Semi-Arid T
ropics (ICRISAT)

International Cent
er for Tropical Agri
culture (CIAT)
International Institut International Lives
e of Tropical Agricult tock Research Insti
ure (IITA) tute (ILRI)
 Why bother about aflatoxins and animals?

• Animals are susceptible to aflatoxins: some more,

some less
1. Animal suffering; an animal welfare issue
2. Reduced animal productivity
3. Aflatoxins in animal-source foods
Health effects observed

• Liver damage
• Gastrointestinal dysfunction, decreased appetite
• Immunosuppression
• Decreased reproductive function, decreased
growth, and decreased production
• Carcinogenicity?
Feeding sheep 1,750 ppb aflatoxins for 3.5
years caused liver/nasal tumours
Interactions

Mycotoxin Main fungi Impact on animal health

Aflatoxins Aspergillus spp All livestock susceptible to different
degrees.
Acute toxicity, hepatotoxic and
nephrotoxic. Carcinogenic and mutagenic.
Growth impairment. Immunosuppression.

Ochratoxin A Aspergillus spp, Nephrotoxic

Penicillum spp Immunosuppression
Possibly carcinogenic

Fumonisins Fusarium spp Toxic to liver and central nervous system

Possibly carcinogenic

Zearalenone Fusarium spp Swine highly sensitive, cattle less sensitive.

Endocrine disruption. Estrogenic effects,
reduced reproduction, feminisation,
malformations.

Trichotecenes Fusarium spp Gastrointestinal disturbance. Reduced feed

intake. Ill-thrift. Immunosuppression.
 Agricultural services Veterinary services
Economic
flow Feed Feed Milk
producer seller Farmer Consumer
retailer

Corn/feed Treatments
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
Animal source food

• Aflatoxins are transferred to animal products

• 1-7% of aflatoxins in feed is metabolized and
transferred to milk
• Some studies show no transfer to eggs, other
show low levels (5,000:1 -125,000:1)
• Meat intermediary transfer: around 1000:1 ?
• Reduced if stop feeding
Standards and policies

FDA limits

Ref: Wu. VOL. 38, NO. 15, 2004 / ENVIRONMENTAL SCIENCE & TECHNOLOGY
 Understanding behaviour

Qualitative study
• 9 districts, 27 villages, 54 FGD, 206 women & 199 men
• Pilot screening for aflatoxins: most feed samples <20 ppb (n=81 mean 10.1 ppb)
• Women greater role in deciding what to feed cattle
• Common to feed mouldy food to livestock
• Women are more dependent on observation for knowledge of moulds
• Women more likely to report taste of maize as an indicator of moulds
• Men and women share more decision making than literature suggests
• Men and women disagree which gender has responsibility
 Kenya dairy value chain
• Feed collected from 5 countiesa
– From farmers: 0.02 ppb to 9,661ppb and the
positive samples ranged from 75% to 100%
– Milk samples: Up to 6999ppt, up to 26% of
samples
– Samples exceeding 5ppb
• 25% to 100% of the feed in farms
• 85.7% to 100% of the feed from feed retailers
• 20% to 100% of the feeds from feed manufacturers
– Estimate cost of feed discarded if enforced: >20 billion USD
– Estimated impact of this on lost milk production>30 million USD

a
Mugangai et al. 2016, submitted
 One-year survey
300

250

200

150 dagoretti
Westlands

100

50

0
1 2 3 4 5 6 7 8 9 10 11 12
 One-year survey
1200

1000

800

600 Average of ppt

Max of ppt

400

200

0
Pasteurized Boiled Pasteurized Raw UHT Pasteurized
Lala Milk Yoghurt
Producer Number Mean price Geometric
KES/litre mean
Mean aflatoxin
(range)
M1 levels Standard
(ng/kg) deviation Min Max
Farmers 75 65 (45-110) 116.5 153.3 <LOD 1069.5 65.6 a

Company A 74 155 (80-610) 57.0 43.9 7.6 272.3 46.4

Company B 12 101 (90-120) 296.9 206.1 59.0 743.3 226.9
Company C 51 128 (60-233) 37.2 33.9 <LOD 166.1 22.7 b
Company D 37 125 (86-233) 38.9 33.5 <LOD 156.1 23.7 b
Others 42 176 (76-660) 111.3 169.9 7.3 1078.5 68.0 a

Table 2. Aflatoxin M1 levels in milk samples of different origins purchased in Nairobi, Kenya
Geometric means with the same superscript were not significantly different
LOD: Limit of detection (2 ng/kg)
 Kenya: urban milk
• Milk collected from milk retailers
– Informal dairy traders in Dagoretti
– 58% knew about aflatoxin, but only 6% thought
milk was not totally safe after boiling
– Milk samples: mean AFM1 was 128.7 ppt, up to
1675 ppt. 55% of samples exceeded 50 ppt and 6%
500 ppt
– Women consume 1 litre per day!
Kiruni et al. 2016, Afr J Food, Nutr Ag Dev
 Kenya: urban milk
• Child exposure study
• Korogocho & Dagoretti
• 41% of children were stunted
• 98% of foods contained aflatoxin
• AFM1 exposure associated with decreased Height for
Age score
14%

27%

moderate stunted
Normal
severe stunted

Kiarie et al. 2016, Afr J Food, Nutr Ag Dev

59%
 Urban consumers
Completed and results
Willingness to pay study: 600 consumers
• Dagoretti:
• 55% know of aflatoxin (45% of these believe it can be
transferred to milk)
• 53% think aflatoxin is a serious threat.
• CBD and Westlands:
• 80% know of aflatoxin(51% of these believe it can be
transferred to milk)
• 32% think aflatoxin is a serious threat
• All income willing to pay a premium aflatoxin
assured milk
 Some studies in Africa

Location Samples Positive >50 ppt >500 ppt Max level Reference
detected

Dar es Salaam, 37 92% 24% 855 ppt (Urio et al. 2006)

Tanzania

Nairobi, Kenya 128 100% 63% 2,560 ppt (Kiarie et al. 2016)

Rural Kenya (4 AEZ) 512 40% 10% 0.6% 6,999 ppt (Senerwa et al. 2016)

Libya 49 71% 3,130 ppt (Elgerbi et al. 2004)

Addis Ababa, 110 100% 92% 26% 4,980 ppt (Gizachew et al. 2016)
Ethiopia

Cameroon 63 16% 9.5% 527 ppt (Tchana et al. 2010)

 Mitigation options

• Aflatoxins can be mitigated all along the dairy

value chain
 Costs
 Implementation
 Side effects
 1. Stop aflatoxin production

Corn/feed
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
 In the field: storage
• Improved varieties- more resistant crops
• Bio control: AflaSafe™, AflaGuard™
• Improved drying
• Improved storage
• Good Agricultural Practices (GAP)

 Reduces aflatoxins for both humans and

animals
 Costly?
 2. Stopping the bad feed

Corn/feed
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
 Objectives of feed standards

1. Protect humans from harmful aflatoxins in animal source foods

• Milk is the most high risk animal source food because relatively large amounts
of aflatoxins are carried over, and milk is consumed especially by infants

2. Safeguard the benefits people derive from livestock

• Income, food and nutrition security, draft power, manure and social/cultural
benefits
3. Protect value chain actors from fraudulent or defective products
4. Encourage fair trade, and economic growth through promoting
standards and credibility

5. Safeguard the welfare of animals

 2. Stopping the bad feed
• Feed regulations
 Implementation
 What do you do with illegal feed?
 Costs?

• Market incentives
 Poor people?
 Not sustainable
 3. Within the cow

Corn/feed Binder
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
Standards for Anti-Mycotoxin Additives (AMAs) in Feeds

Clays (aluminosilicates)
• Most effective binder but different clays vary
in effectiveness. Up to 90% reduction.
Yeast/bacterial cell wall extracts
• Provide other useful nutrients, but evidence
on effectiveness is mixed
Other binders
• Some are promising but less evidence of
effectiveness

• Over 100 companies offering AMAs

• In the Brazilian market, where approximately 100
AMAs for poultry and swine were evaluated, only
about 30% were effective
The case for binders

• Multiple benefits:
1. Increase animal productivity
2. Reduce aflatoxins in animal-source foods
3. Create safe “sink” for aflatoxin
4. Improved animal welfare
• Food safety/security tradeoff  win-win opportunity
• Current trial will provide evidence on effectiveness
 Feeding livestock contaminated feed
Less aflatoxin
Aflatoxin contaminated contaminated crops
feed given to livestock reach humans- less
instead of humans crops reach food
market

Less animal-source
Livestock produce less food produced,
because of toxic effects reduced livelihoods of
farmers

A reduced amount of
Animals metabolize aflatoxins may reach
toxins humans through
animal-source food
 Reducing aflatoxins in milk using binders

• Baseline survey to collect data on:

– Levels of aflatoxins in milk
– Feeding practices
– Farmer awareness
– Farmer willingness to use mitigation methods
– Farmer willingness to pay for binders or other
mitigation methods
 Study sites

• Urban/Peri-urban
– Kasarani
– Kisumu
 The trial
• 20 trial farms and 10 control farms recruited
in each site
• Trial farms gets
• Training
• Binders to last for 6 months
• One mazzican
 Training
• A training package about food safety, microbes and
aflatoxins
• General training on milk production animal health
and animal feeding
Follow up

• Regular follow up and endline survey of farmers

• Preliminary results:
• High dosing of binder reduces aflatoxin
• Farmers perceive improved production
 4. In the milk?

Corn/feed
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
 4. In the milk

• Biological control??

 Research still ongoing

 Pasteurization not working
 5. Stopping consumption of contaminated milk

Corn/feed
AB1 purchased

Aflatoxin
flow AB1-> AM1
AB1
AM1

Corn/feed
produced AB1 AM1
Milk produced
at farm at farm

Human
exposure

Farmer Consumer
 5. Stopping consumption

• Legislation
• Awareness and market incentives

 Implementation
 What do you do with illegal milk?
 Costs?
 Poor consumers?
 Food
security

Change:
Food
safety

To: Improved Improved

Better
food food
health
security safety
Take-home messages

• Fungi are everywhere; we can’t avoid them completely

• Aflatoxins are one of many serious hazards transmitted by
foods
• Livestock is affected by aflatoxins, and so are animal-sourced
food
• Livestock feed sector + binders can suck contaminated grain
out of human food chain
• Potential for regulation to cause harm (burden on agricultural
sector, concentrating contaminated among poorest)
• Need to research what works in Pakistan
Conclusions

There is no silver bullet to eradicate aflatoxins

A battery of interventions to provide safer food in a

world full of food safety hazards!
Animals may be both part of the problem and part
of the solution
 Acknowledgements

The Kenya work is financed by the Ministry of Foreign Affairs, Finland

in partnership with the International Food Policy Research Institute,
Luke Finland, Biosciences eastern and central Africa (BecA) hub at the
International Livestock Research Institute

It contributes to the CGIAR Research Program on

Agriculture for Nutrition and Health
 better lives through livestock

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